S Jenifer Maria, Radhesh Hegde
Abstract: A study on Efficacy of Intravenous Diclofenac and Ketorolac on Post Laparoscopic Cholecystectomy pain. Introduction: Laparoscopic cholecystectomy is the most common minimal access procedure performed. Incisions of the operative ports are the main cause of abdominal and shoulder tip pain after laparoscopy and are probably caused by gas retained in the peritoneal cavity. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are generally used for management of postoperative pain after laparoscopic cholecystectomy Materials and Methods: Fifty patients aged 20 60 years scheduled for Laparoscopic Cholecystectomy and with ASA physical status I or II were divided into two equal groups. All patients received uniform pre-operative and intra operative medication according to body weight. Patients of Group D received Injection Diclofenac Sodium 75mg IV in 100mL Normal Saline and Group K received Injection Ketorolac 30mg IV in 100mL Normal Saline. The post operative pain score was recorded at 0, 2, 4 and 6 hours. Rescue dose of analgesia was given if VAS score was more than 3 or on demand. Results: VAS scores were not significantly different among the two groups at 0 and 2 hours. At 4th post operative hour, the scores were significantly higher in Group K; 3.280.45 vs 3.560.50, p= 0.04. The time of rescue analgesia administration in group D was 292 55.56 minutes and group K was 233 34.69 minutes. Conclusion: A single dose of intravenous Diclofenac can be recommended as an effective and safe alternative compared to intravenous Ketorolac for post operative pain relief following laparoscopic cholecystectomy.
Keywords: Diclofenac, Ketorolac, Laproscopy, Cholecystectomy